Understanding language

Difficulty following instructions 

This may be presented by the child making errors, reliance on following what their peers are doing or looking blank/anxious. The difficulty may increase with the increase in length of the instruction, with the grammatical complexity or the inclusion of unknown words. 

Support strategies: 

• Set the child's attention before giving instructions. 
• Be aware of how many parts to an instruction the child can follow. 
• Slow down delivery and uses pauses to allow the child time to process what has been said. 
• Give individual instructions to encourage independent listening, rather than allowing the child to follow what peers do. 
• Give instructions in the correct time-ordered sequence. For example, "Put your books away before you go out to play" rather than "before you go out to play put your books away". 
• Reinforce abstract instruction with specific instructions. Such as reinforcing "it's PE time" with "this means get your PE kit and put it on so we can go outside". 
• Play games that involve giving instructions at an appropriate level. Examples include: 
  • Simon Says: Instructions are short such as "put your hands on your head" or "touch your nose". 
  • More complex instructions such as "find the clown whose hat has a feather in it" where there is an array of clowns to look at. 
• Teach language that is needed to carry out instructions successfully. 
  • Prepositions when giving instructions that involve placing objects. For example "in", "on", "under"  and "next to". 
  • Relative clauses and categories for the child to be successful in following instructions, such as "find the person who is carrying office equipment". 
• Barrier games.
  • This is where the child and adult sit on either side of a barrier and each has a set of objects. Instructions are given to position the objects in relation to each other. Remove the barrier and see if the objects are in the same place.  
  • Another game to play is to use photocopied pictures to draw crosses on based on the instructions given. Or use blank paper to draw on according to instructions. 

Difficulty responding to questions

Presenting as giving incorrect, off-topic responses, or appearing blank and unable to respond. Difficulty may be experienced with 'why'/'how' questions or questions including words such as 'might' or 'should'. For example "what might the boy do next?" or "what should he do if...?". 

Support strategies:

• Encourage active listening strategies so that the child is confident to say they have not understood. 
• Simplify questions and use simple language structures to aid comprehension. 
• Use visual supports. 
• Check understanding of basic questions words such as "who? what? where? why? or how?". Address difficulty with each one separately.
• Consider whether it is the content or the question, the form or complexity or is weak memory responsible. 
• Be aware of the level of questioning the child can manage and build on this level. 
• Adapt your language with broader comprehension difficulties.
• A lot of confusion can occur around tense. Use symbols to indicate past, present and future. 
• Evaluate what level of sentence grammar is understood in order to not oversimplify where it is not necessary. 
• Be aware of the 'Blanks Levels of Questioning' which demonstrate a hierarchy of difficulties: 
  • 1. Very basic here and now questioning (who? what? where?). 
  • 2. More detailed here and now questioning and requests to describe. (What's happening? Find something that is a fruit. How are these different?). 
  • 3. Stories, events and definitions. (Tell me how to...? What is a... [definition required]? What will happen next?). 
  • 4. Questions around analysing and reasoning. (How could he...? What will happen if...? Why?).

Difficulty understanding the grammatical structure of what's been said

A child may present with confusion or with responses that do not match what has been said or do not follow the grammatical pattern. They may also seem to have a poor understanding of the rules that govern word structure, and the rules that govern word sequence and sentence structure. 

A child may also not understand the plural forms of words, only understand part of a sentence or have difficulty extracting meaning from complex sentences. This could include sentences in the passive voice, or sentences with subordinating clauses. 

Regular lack of understanding can lead to becoming accustomed to failing to understand. This may result in passive acceptance, and a need to be taught to ask for repetition or simplification. 

Support strategies:

• Use simple language structures to aid comprehension. 
• Adapt your language as you would with broader comprehension difficulties. 
• Use visual aids. 
• A lot of confusion can occur around tense. Use symbols to indicate past, present and future. 
• Evaluate what level of sentence grammar is understood in order not to oversimplify where it is not necessary. 
• Encourage active listening strategies so that the child is confident to say when they have not understood. 

Difficulty understanding due to a combination of the above

A child may present a combination of the above difficulties. They are highly likely to seem lost, uncertain, anxious and eventually disengaged. 

Support strategies:

• Depending on the severity of the difficulty, alternative methods of understanding and communication may be needed. These can include Makaton signing, ICT and communication books/boards. 
• Symbol communication systems such as 'Widgit' will aid all children with comprehension difficulties. They are an essential tool.